title: Factors affecting accurate drill sleeve insertion in locking compression plates.
abstract: BACKGROUND
  Accurate positioning of locking screws depends on accurate insertion of the drill sleeve into the locking compression plate (LCP). The purpose of the present study was to determine factors affecting accurate drill sleeve insertion.
  
  
  OBJECTIVE
  Tilting and shallow locking screw holes and combination-type holes make it difficult to insert the drill sleeve in the LCP.
  
  
  METHODS
  Twenty-seven 3.5mm LCP metaphyseal insertion holes were selected (Philos(®), LPHP(®), DMTP(®), low-band DMTP(®) [Synthes, Solothurn, Switzerland]). Two orthopedic surgeons checked the time taken for accurate insertion of the drill sleeve into the plate. Variables relating to LCP drill sleeve insertion time were analyzed.
  
  
  RESULTS
  It took an average 6.6seconds to insert the drill sleeve accurately in the holes. Insertion time increased with the tilt of the screw hole but not with shallowness. Insertion time in combination-type holes was longer (8.8seconds) than in single locking holes (5.6seconds).
  
  
  CONCLUSIONS
  Tilted screw holes and combination-type holes affect the insertion of the drill sleeve into 3.5mm LCPs.
  
  
  METHODS
  Level IV, experimental study.
authors.affiliation: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Kim
authors.forename: J-W
authors.initials: JW
authors.lastname: Kim
authors.forename: H-S
authors.initials: HS
authors.lastname: Yu
authors.forename: H-S
authors.initials: HS
authors.lastname: Lee
authors.forename: H-K
authors.initials: HK
authors.lastname: Oh
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D011312:Pressure; D011474:Prosthesis Design; D015203:Reproducibility of Results
keywords: Drill sleeve; Internal fixation; Locking compression plate; Locking screw; Osteosynthesis